Do You Agree With My Choice For 800cc High Profile Under Muscle Saline Implants?(photo)

The larger you go, the greater percentage of your final breast volume will be implant, and the more your breasts will look, behave, and feel like the implants.  Because the texture of silicone gel, due to its viscosity, is more natural than saline, the larger you go, the more advantageous gel implants become.  My recommended max for you is 600-650 ml, depending on chest width, and at that size, gel is preferred over saline.  Large saline implants also more prone to rippling and wrinkling.

800 cc breast implants are very large implants.  I would be interested in seeing how you came to this conclusion.  In my practice, we do a combination of things to determine the size that you would be happy in. 


Trying on implants in a bra and under clothing

Dimensional analysis fitting the "right" dimension of implant to your frame

3D imaging so that you can "see" the changes in your body before surgery


If you feel that you have accurately determined 800 cc is the correct implant size for you, you may be right (but I doubt it).  In my practice, this is a very large implant and would likely do best in stages with an initial implant in the 500 cc range.

800 cc saline implants WILL give you a rounded upper pole and very augmented appearance.  The feel of the breast will be very unnatural, which it sounds like is not what you are interested in.

Thank you for including photos, and the comment that you "don't want upper pole fullness." I'm not sure what "prep" is, but you should take the suggestion that others have given and wear 800cc implants in your bra for a few hours and see what that looks and feels like. How did you and your PS arrive at 800cc?

800cc is over 3 cup sizes larger than what you have now, and even though you have some breast droop, your nipples are above your inframammary crease, and augmentation alone is all that is needed to give you a good result. However, adding over 3 cup sizes into your skin brassiere will undoubtedly give you a high, tight, rounded look that certainly adds upper pole fullness--that volume has to go somewhere. It may also give you an inframammary double bubble deformity as your implant causes a "new" lower inframammary crease below your natural one.

Furthermore, you should be considering silicone for the softest, most natural feel and to avoid the possibility for requiring re-operation if your saline implant(s) leak and deflate, which cannot happen with the latest generation of cohesive silicone gel implants. Below the muscle will help to keep the upper pole fullness down compared to above the muscle, and below the muscle also has the lowest likelihood of bacterial contamination (from intraductal bacteria) that can lead to capsular contracture (which will give you HARD, high, tight upper pole fullness).

Truly, I am usually the plastic surgeon on this site who champions patient choice--in coordination with the surgeon's assessment of your anatomy--regarding implant size, and I do use 800cc implants on occasion. I just really question your surgeon's judgement and experience if he/she condones, agrees, or promotes this choice for your anatomy. Have you shown your surgeon photos of patients or nude models with the breast size and appearance you desire?

Reschedule surgery and get another or two consultations and see if 800cc is offered by experienced, ABPS-certified plastic surgeons with lots of breast experience. If you can get one or more PS to agree with this plan, then you can always go ahead. But if not, you should realize there IS a reason that virtually all of your on-line experts are in agreement that this will be a huge mistake, and one that perhaps cannot be undone by simply "exchanging for smaller implants." You can always go bigger, but going smaller is much more problematic.

Good luck and best wishes!